Partners June Provider Webinar
Make sure to join us for the quarterly Provider Webinar to learn the latest information about the Partners’ Network.
Date and Time: Wednesday, June 13, 2018 at 1 p.m.
Meeting will be held via Webinar. Registration is required
To register, visit https://register.gotowebinar.com/register/3508865250810933761
If you have questions about the Provider Forum or future Provider Webinars, please contact Roanna Newton at 828-323-8054 or email rnewton@partnersbhm.org.
Limited Funding Opportunity: Electronic Health Record Incentive Program for BH and IDD Providers
The N.C. Department of Health and Human Services Office of Rural Health (ORH) and Division of Medical Assistance (DMA) have partnered with the N.C. Health Information Exchange Authority (NC HIEA) to launch a program that will assist behavioral health, mental health, and intellectual development and disability practices with purchasing electronic health record (EHR) technology and establishing connectivity to the state-designated health information exchange, NC HealthConnex.
Pursuant to N.C. Session Law 2017-57, health care providers that accept Medicaid reimbursement for the provision of health care services must connect to NC HealthConnex, which is housed within the N.C. Department of Information Technology (DIT). Physicians, hospitals and mid-level practitioners that receive Medicaid reimbursement and currently have electronic health record (EHR) technology must connect by June 1, 2018. All other providers that receive funds from the State for the provision of health care services must connect by June 1, 2019, even if they do not currently have an EHR system.
Who is Eligible?
This program is designed to support health care practices that:
- are Medicaid-enrolled outpatient practices that have an active NPI number in NC TRACKS;
- provide behavioral health, mental health, or intellectual and developmental disorder services (See taxonomy list);
- attest that they have not received funding for EHR adoption or meaningful use;
- attest that they do not have electronic health record technology or attest that they do have a practice management system as of January 1, 2018, that could be upgraded to an electronic health record; and
- for calendar year 2017, had behavioral health, mental health, or intellectual and developmental disorder services providers make up 75 percent of their affiliated health care providers based on NC TRACKS data.
Note: The NC HIEA strongly recommends that providers choose a vendor that is already engaged in the NC HealthConnex connection process to ensure that they meet the technical requirements for connectivity. See list of vendors on How to Connect. If the vendor you’re working with is not currently on this list, please provide the Technical Specs document that requires EHR software that is minimally capable of sending HL7 messages, version 2 and higher.
For more information and to apply for this program, visit the Office of Rural Health website. Applications close May 31, and are accepted on a first-come, first-serve basis.
Your Feedback Wanted! 2018 Community Needs Assessment
Partners is conducting a survey to find out what people living across eight North Carolina counties think about the accessibility of services for mental health needs, substance use issues and intellectual or developmental disabilities in their local communities. As providers in these counties, we need your help! Our Community Needs Assessment Survey gives you the opportunity to tell us what services are needed and share where other services might be improved.
The survey is open from Monday, May 21, through Friday, June 15. You can access the survey at
https://www.surveymonkey.com/r/Partners_NeedsAssessment2018.
To participate as a provider, click the survey link that best applies to you. Please encourage your consumer and family members to participate in the survey as well. You are welcome to email the consumer/family member link to consumers, refer them to the Partners website, or print off copies that can be faxed to Roanna Newton at 828-325-8178. Thank you for helping us improve healthcare services in western North Carolina!
NC DMA Request Public Comment: Mobile Crisis Management, Psychiatric Rehabilitation
The North Carolina Division of Medical Assistance has posted the following new or amended Medicaid clinical coverage policies for review. Please visit https://dma.ncdhhs.gov/get-involved/proposed-medicaid-and-nc-health-choice-policies to review all policies available for public comment, or click on the links below. Comment should be submitted to dma.webmedpolicy@dhhs.nc.gov by June 17, 2018.
|
Proposed Policy |
Date Posted |
Submit Comments |
Comment Period ends |
| 8A-3, Mobile Crisis Management | Posted May 3, 2018 | dma.webmedpolicy@dhhs.nc.gov | June 17, 2018 |
| 8A-4, Psychiatric Rehabilitation (Psychosocial Rehabilitation) | Posted May 3, 2018 | dma.webmedpolicy@dhhs.nc.gov | June 17, 2018 |
Cultural Competency Expectations
As explained in Communication Bulletin #62, Partners expects all providers to ensure that Cultural Competency is an integral component of quality services for our mutual beneficiaries. Cultural Competency expectations were rolled into the Provider Monitoring process as of January 1, 2017. Monitors are reviewing providers for evidence of the following, at minimum:
- Ensure that your cultural competency plan includes the mission and/or vision statement and indicates the promotion of cultural diversity, cultural competency, and linguistics as an integral part of the system. Examples may include annual reports, brochures, communications to staff, website information, etc.
- Ensure that there is a written plan for cultural competency that promotes awareness, respect, and attention to the populations and persons served. Evidence would include board or governance approval, frequency of review and revisions, and a written approval process.
- Ensure that staff orientation includes instruction on the vision, mission, policies and procedures and practices of the organization. Examples of evidence may include a provider orientation manual, staff information regarding cultural competency, handouts and/or printed material, staff training, etc.
- Ensure that there is a process to communicate with individuals needing interpretation/translation services. Examples of evidence may include relationships in the community for interpretation and translation services for staff and individuals.
During the Monitoring process, providers have consistently requested a sample template to guide in the development of the required Cultural Competency Plan. Partners is pleased to announce we have heard your request and have developed an optional Cultural Competency Sample Template Plan. This template is posted on the Provider Knowledge Base at https://legacy.providers.partnersbhm.org/cultural-competency/.
Requests for Services
RFI #0518-002 NADD Certification (Updated May 15, 2018): Partners has updated its Request for Information to solicit responses from organizations to participate in a membership and certification process through NADD.
It is important for organizations providing services to individuals with dual diagnosis and complex needs to consider participating in this RFI. The certification process will assist staff to build the skills needed to better serve individuals with multiple diagnoses and needs. Certification is a way to assure payors and consumers that staff have the skills needed to deliver quality services. As Partners continues to support value, innovation, and performance across the network, the NADD certification is certainly an opportunity for providers to demonstrate a focus on quality. This certification may potentially offer opportunities for enhanced compensation in the future.
RFI #0518-002 is specifically to identify organizations currently in Partners Provider Network and their employees who are qualified and interested in becoming certified through NADD for Clinical Certification (NADD-CC) and Direct Support Professional Certification (NADD-DSP). To view the announcement, description, and details, please visit https://legacy.providers.partnersbhm.org/request-for-services/#RFS.
RFI #0518-003 Individual Placement and Support-Supported Employment (IPS/SE) for Burke and Catawba Counties: Partners Behavioral Health Management’s RFI #0518-003 will be used to specifically identify any current IPS/SE Providers interested in and qualified to provide Individual Placement and Support-Supported Employment (IPS/SE) in Burke and Catawba Counties. As written in the NC DHHS service definition, IPS/SE is a person-centered, behavioral health service with a focus on employment, that provides assistance in choosing, acquiring, and maintaining competitive paid employment in the community for individuals 18 years and older for whom employment has not been achieved or employment has been interrupted or intermittent. This service is co-located with an agency’s behavioral health treatment services to ensure consistent behavioral health integration. Depending on the volume of responses Partners may select a provider to add this service or will issue a full Request for Proposals.
The RFI, once posted on May 23, 2018 at https://legacy.providers.partnersbhm.org/request-for-services/#RFS, will offer an overview of Partners, requirements to submit a RFI response, and links for additional resources. Please review the RFI and if you are interested in being considered for provision of these services with Partners, you must register to attend the Mandatory Bidder’s Conference to be held on Wednesday, June 6, 2018 from 1:00 pm-4:00 pm, in the Hickory Basement Multipurpose Room at 1985 Tate Blvd. SE, Hickory, NC 28602.
If you have questions about either of these RFIs, please contact Vanessa Anderson by email at vanderson@partnersbhm.org or call 828-323-8062.
Claims Information
Providers are reminded to use the email claimsdepartment@partnersbhm.org for all email inquiries so that they are handled in the most efficient manner. Please do not send email directly to individual employees.
| Medicaid—April 2018: Number of Days to Process and Pay All Claims | |
| Received Date to Paid Date: | 8.8 |
| Top Five Medicaid Claim Denials—April 2018 | |
|
Claim Denial |
Provider Recommended Action Steps |
| Duplicate Claim | Claim has previously been submitted and adjudicated. Do not refile. |
| The procedure code/bill type is inconsistent with the place of service | Contact your MCO. |
| Billing Taxonomy submitted is not associated with the Billing NPI | Rebill claim with a valid taxonomy/NPI information. |
| Claim received after billing period | Write off charges as non-billable. Do not rebill. |
| Service is not authorized | Verify Service Authorization for consumer. Contact Utilization Management. |
Claims Accuracy and Timeliness Audit Results: Partners Behavioral Health Management recently received the results of the Claims Accuracy and Timeliness Audit performed on behalf of North Carolina Department of Health and Human Services, Division of Medical Assistance prepared by HMS.
| Claims Accuracy and Timeliness Audit: Summary Findings | ||
|
Audit Type |
Result |
Finding |
| Timeliness of Provider Payments (within 30 days) | 99.94% | Compliant |
| Claims Processing Accuracy | 99.95% | Compliant |
| Financial Accuracy | 99.95% | Compliant |
The results of the audit are statistically valid and can be extrapolated across the entire population of claims. The random audit can identify systemic processing errors, if they exist, within the sample. The random audit accomplishes the objective related to compliance and due diligence. In researching, Partners found that the claims identified were processed and paid correctly based on Alpha system edits.
Timely Filing Override Requests: Please make sure claims are being submitted according to the timely filing guidelines available at https://legacy.providers.partnersbhm.org/claims-information/. If claims deny for any of the reasons below, make sure you submit timely filing override requests within the time frames.
Timely Filing Requests should be sent directly to claimsdepartment@partnersbhm.org prior to submitting the claims.
AlphaMCS Portal University is an available resource and guide for navigating AlphaMCS. If you need additional claims training, email rcolvard@partnersbhm.org to schedule a time for training.
2018 Perception of Care Survey – Completed Surveys Due June 8
Providers selected to conduct this year’s Consumer Perception of Care (PoC) Survey are reminded that all surveys need to be returned by June 8, 2018.
Providers can return the surveys to Partners by:
- sending/delivering to your provider specialist; or
- sending/delivering to April Corder at the Gastonia office, 901 S. New Hope Road, Gastonia, NC 28054.
Please direct requests for additional surveys, surveys in Spanish, or any other questions regarding this year’s survey implementation to April Corder at 704-884-2591, acorder@partnersbhm.org or to Bill Rankin at 704-884-2688, brankin@partnersbhm.org.
Partners expresses its gratitude for your assistance in administering the 2018 Perception of Care survey.
Housing and Social Determinants of Wellness
May is Mental Health Awareness Month, and one of building blocks for awareness are Social Determinants of Health. These determinants are the economic and social conditions that influence a person’s health status and can include access to food, sanitation, education, and housing to name just a few. A person’s health is affected by so many things other than genetics.
Housing is a key component of these determinants, and specifically, housing instability affects one’s overall health. Housing instability affects millions of Americans and is seen on the continuum between homelessness and stable housing. The conditions of housing instability include poor sanitation, exposure to allergens and substandard housing structures. Public Health Research has shown that consumers that are experiencing housing instability are more likely to have infectious diseases and chronic health conditions.
Partners works consistently to address housing barriers and improve housing stability through initiatives in each of our catchment area counties. Partners can offer housing information and support with our providers in each area. For more information, please contact Bre Griffin, Housing Educator, at 704-884-2514 or bgriffin@partnersbhm.org.
Positive Trends: Home and Community Based Services Standards
Over the coming months, members of Partners’ Intellectual and Developmental Disabilities Monitoring Team will be sharing some of the trends they have seen that promote self-determination and compliance with Home and Community Based Services (HCBS) standards. Here is an article from Tiffany Graham, MA, QP, CSAC-I, Monitoring Specialist, IDD Care Coordination:
Safety First: During the past quarter, I had the opportunity to engage and be a part of one of our local providers self- governance meetings. This meeting was held at one of the provider’s larger group homes, and it could hold a larger capacity of the individuals served. The meeting was conducted by one of the residents, who served as the “chair” of the meeting. This individual began the meeting by reviewing the rules of the meeting, ensuring that everyone felt empowered to share and discuss their concerns but to also be respectful of each other’s opinion. Each of the member’s engaged in the meeting sharing and discussing valid areas of self-improvement and shared concerns. Safety issues related to riding in the van was a major concern in which many of the individuals discussed how their role assists the driver to ensure their safety. Throughout the meeting, the individuals were very respectful and shared a lot of laughter, demonstrating genuine respect and friendship.
Not often are we on site to see the extra measures our providers take to ensure the safety and overall welfare of our individuals. The information discussed during this meeting is evidence that our individuals share responsibility in ensuring their safety with your continued support and education. Together, we all can continue to improve the lives of others and strengthen our communities!
Partners Training Academy Opportunities
All Partners Training Academy sessions are FREE to registered attendees. Be sure to register at www.PartnersTraining.com.
If you have any questions about Partners Training Academy events, or would like to be added to the waiting list for a training that is already full, please contact Kali Sbalbi, Public Relations Training Coordinator, by emailing Training@PartnersBHM.org or calling 704-884-2669. For more information about attending Partners Training Academy sessions, visit our Frequently Asked Questions page
Certified Peer Support Specialist (Registration)
Monday, June 11 – Friday, June 15, 2018, 8:00 a.m. – 5:00 p.m., Gastonia, NC
Description: Peer Support Specialists are people living in recovery with mental illness and/or substance use disorder who provide support to others who can benefit from their lived experiences. The North Carolina Certified Peer Support Specialist Program certifies that the peer has met a set of requirements necessary to support other individuals with mental health or substance use disorder.
Trainer: Monroe Consulting, LLC – Take Your Heart to Work® Curriculum
NEW! Overview of Personal Outcome Measures – Community Training
Thursday, June 5, 2018, 6:00 p.m. – 8:00 p.m., Gastonia, NC (Registration)
Thursday, June 12, 2018, 6:00 p.m. – 8:00 p.m., Hickory, NC (Registration)
Thursday, June 19, 2018, 6:00 p.m. – 8:00 p.m., Elkin, NC (Registration)
Description: Personal Outcome Measures® are a tool developed by the Council on Quality and Leadership (CQL) to ensure supports and services are truly person-centered. This overview will provide a basic understanding of the Personal Outcome Measures® as Partners BHM prepare to use them in planning.
Trainers: Michelle Stroebel, Intellectual Developmental Disabilities Assessment Team Supervisor, Partners, and Tammy Wellman, Intellectual Developmental Disabilities Systems Manager, Partners
Person Centered Thinking (Registration)
Tuesday, June 19 – Wednesday, June 20, 2018, 9:00 a.m. – 4:30 p.m., Gastonia, NC
Description: Person Centered Thinking (PCT) training serves as a foundation and philosophical framework for everyone who is involved in supporting people with disabilities. This activity-filled, two-day training consists of applied stories, guided exercises, group work, and discussion, wherein the participants acquire core skills in person centered thinking.
Trainer: Evelyn McGill, MA, LPC, LCAS, CSI, NCC, Certified Person Centered Thinking Trainer with The Learning Community
Alerts and LME/MCO Joint Communication Bulletins
Provider Alerts are sent to all providers subscribed to receive Partners’ Provider Communications. Published alerts are available on the Provider Knowledge Base at https://legacy.providers.partnersbhm.org/provider-alert-archive/.
Alerts issued since the last Provider Bulletin:
April 19, 2018 – AlphaMCS Issues & State/IPRS Funded Services Update
April 19, 2018 – UPDATE – AlphaMCS Issues
April 24, 2018 – AlphaMCS Update; NCTracks Recredentialing Changes
April 26, 2018 – AlphaMCS Update
May 2, 2018 – Alpha Update; Billing Services, RFI-NADD Certification; EMDR; Training
May 4, 2018 – EFT Notice & IRIS Downtime
May 10, 2018 – Rutherford County Votes to Seek Alignment with Partners
All LME-MCO Joint Communication Bulletins are located at http://www.ncdhhs.gov/divisions/mhddsas/joint-communication-bulletins.
Joint Communication Bulletins issued since the last Provider Bulletin:
- #J285 Disengagement of Columbus County from Eastpointe
- #J286 Tool for Measurement of ACT (TMACT) evaluations and IPS-SE Providers
- #J287 Clarifying the Reporting standards for Psychiatric Residential Treatment Facilities
Providers are encouraged to review the monthly NC Division of Medical Assistance Medicaid Bulletin. Bulletins are posted at https://dma.ncdhhs.gov/documents/2018-medicaid-bulletin-and-index
Announcements and Reminders
Medicaid Transformation: All providers are urged to stay abreast of the information shared by DHHS regarding Medicaid transformation and the impact it can have on their operations. Information regarding this effort can be found at https://www.ncdhhs.gov/medicaid-transformation. In addition, Partners will also highlight white papers, comment periods, and additional information in future Provider Communication Bulletins.
NAMI South Mountains Behavioral Health Conference: NAMI South Mountains is hosting its annual Behavioral Health Conference on Monday, May 21, 2018 at Foothills Higher Education Center, Morganton, NC 28655. To learn more, visit https://namirutherfordclevelandburke.org/2018-behavioral-health-conference/.
LIP Collaborative Webinar: Partners will host the Licensed Independent Practitioner Collaborative via webinar on Thursday, May 31 from 12 p.m.-1 p.m. This collaborative has been developed, in response to needs identified in the Partners BHM 2016 Needs Assessment and Service Gaps analysis and our goals are to:
- improve communication between Partners BHM and Licensed Independent Practitioners
- increase the use of the slot scheduler by Licensed Independent Practitioners to increase service capacity
- identify training needs
- identify potential barriers to service and solutions to those barriers
To register, visit https://register.gotowebinar.com/register/6119423614149228802.
Relationships, Respect, and Resiliency Summit: This event is for any parent or professional working with youth. Topics include Whole Person Integrated Care, bullying, and sexting, working through trauma (Crisis Resiliency Model tools) and more!
Date and Time: Monday, June 11, 2018
- 11 a.m.-5 p.m.—Professional Sessions
- 5:30 p.m.-7:30 p.m.—Parent Roundtable and Moderated Discussion
(Lunch and dinner are included in the registration)
Location: Statesville Civic Center, 300 S. Center Street, Statesville, NC
To register, click here. If you have questions or would like to learn more, please contact Melissa Poteat, Iredell County Juvenile Crime Prevention Council, at 704-878-3041.
An Introduction to Child and Family Teams: A Cross System Training from the Family’s Perspective: Partners is offering a free training, “An Introduction to Child and Family Teams: A Cross System Training from the Family’s Perspective” on June 21 and 22, 2018, Children’s Hope Alliance, Little John’s Chapel, 107 Grannis Lane, Statesville, NC. CFT 1 is a two-day experiential training with a goal of providing an overview of Child and Family Team meetings from the family’s perspective. The training seeks to reinforce the idea of “one family, one plan” by addressing Child and Family Teams through the lens of multiple systems as they affect families in their everyday lives. Agency representatives and parents/family members over 18 years of age are encouraged to attend this training.
There is no cost for this training. To register, click here. Deadline to register is Friday, June 15, 2018, and the session must have a minimum of 10 participants to occur.
Healthy Living: Enjoying Life Physically, Mentally, and Emotionally: Tabernacle Baptist Church and Kappa Alpha Psi Fraternity, Inc. are presenting this mental health symposium on Saturday, June 30, 2018 from 9 a.m.-3 p.m. at Tabernacle Baptist Church, 519 West 19th Ave., Gastonia, NC 28052. To learn more call 704-864-4051.